SET OF DEVICES AND METHOD OF TREATING BILATERAL PUBIC BONE FRACTURE WITH ACCOMPANYING SYMPHYSIS RUPTURE Russian patent published in 2025 - IPC A61B17/80 A61B17/68 

FIELD: medicine.

SUBSTANCE: set of devices for treating a bilateral fracture of upper branches of pubic bones with accompanying rupture of symphysis includes two nails for fixation of fractures of upper branches of pubic bones of pelvis, plate for fixation of rupture of symphysis and screws. Two nails for fixation of fractures of upper branches of pubic bones of pelvis each contain two holes for installation of screws. Plate for fixation of rupture of symphysis is made with possibility of installation on upper branches of pubic bones of pelvis above symphysis and represents a flattened C-shaped curved part containing two arms located symmetrically relative to perpendicular transverse plane passing through centre of plate, where each arm is provided with a pair of holes for screws, wherein angle αformed by axes drawn through the centres of each pair of holes ranges from 100 to 120 degrees, inclusive; and a hole for a locating, temporary fixing pin. Distance between holes in plate corresponds to distance between holes for installation of screws in nails. Screws are made with possibility to pass through holes of nails and plates. Method of treating bilateral fracture of upper branches of pubic bones with accompanying rupture of symphysis is characterized by the fact that at first stage surgical suprapubic open approach is performed with subsequent inspection of area of rupture of pubic symphysis and elimination of the detected diastasis with the help of reposition pelvic forceps, at the second stage, the fractures of the upper branches of pubic bones are fixed on both sides with locking nails from the above set containing two transverse holes for fixation of screws. At the third stage, a plate from the above set is installed to eliminate the rupture of the symphysis, with placement of its holes in the projection of the holes of the nails, followed by locking the nails with screws from the above set, which are passed through the holes of the plate. For fixation of fractures of upper branches of pubic bone with locked nails at the second stage under X-ray control of C-arm, guide pin is delivered through external angle of body of pubic bone from bottom to top and from front to back towards cotyloid cavity along its upper branch intraosseously with provision of preservation of internal cortical wall. Anterior cortical wall of the pubic bone is drilled along the guide pin with a cannulated drill, the pin and the drill are removed, and the first nail preliminarily fixed in the guide is inserted through the surgical approach until its proximal part is immersed in the bone canal. Guide is detached, and the fracture of the superior branch of the pubic bone is fixed on the other side with a second locking nail with the proximal part of the nail fully immersed in the bone canal. Further, the plate is installed at the third stage without removing the guide from the second installed nail. Plate is laid along the upper surface of the pubic articulation so that its middle is in the middle of the matched pubic symphysis. Plate is temporarily fixed with a pin through the appropriate technological hole. Holes of the guide are aligned with the holes in the plate of the first arm, and under the control of the C-arm, the nail is locked by two screws, which are passed through the holes of the first arm of the plate, starting from the hole closer to the pubic symphysis. Thereafter, the guide is detached and attached to the proximal part of the first nail. Thereafter, this pin is completely immersed in the bone canal; under the control of the C-arm, the nail is locked by two screws, which are passed through the holes of the second arm of the plate, starting from the hole located closer to the pubic symphysis. Thereafter, the guide is detached and removed from the incisional wound.

EFFECT: inventions are aimed at increasing the effectiveness of treatment with reducing the number of surgical injuries.

16 cl, 12 dwg, 1 tbl, 1 ex